advice needed

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Im an RN and work at an LTC/Skilled rehab facility. Ive been working at this facility for 8 months and have never had any write ups or anything management has had to reprimand me for. I go into work today, and the DON asks to see me in her office. she and the administrator were both there. the DON hands me a copy of the MAR. it was for a lidocaine patch to the lower back that was to be put on by the day shift nurse at 0800 and taken off by myself, the evening shift nurse, at 2000. I circled the past two nights and wrote on the back of the MAR that the patch was not available - as i could not find the patch anywhere on his back. I even had an STNA double check for me to make sure I wasnt blind. He could not find the patch on his lower back either. The DON told me that the STNA found the patch on his lower back both of the following mornings and said I never took it off of him. I attempted to plead my case, telling them I did indeed check for patch placement, as did an STNA, however they put me on suspension. Can I get fired over this?

Specializes in 15 years in ICU, 22 years in PACU.

So they trust the word of an STNA (who found the patches) over the word of an STNA and you (who didn't find the patches). This may be a time to institute a policy that it takes two people to sign off on placing a patch and on removing a patch

If you didn't remove the patches as ordered it is a medication error but not near something as ominous as lost fentanyl patches which sets one up for accusations of diverting.

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This seems ridiculous over a lidocaine patch. I agree with other posters that something else is going on. Best of luck to you.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
This seems ridiculous over a lidocaine patch. I agree with other posters that something else is going on. Best of luck to you.

I agree, your DON is being ridiculous. You looked, the student looked, and it wasn't found. You circled your initials and were honest that the patch was not seen, so therefore you couldn't remove it. What do they expect you to do in this situation. If you can't find it, you can't find it. Not like you can magically conjure one up. Honestly your workplace administration sounds like idiots. Do you think they are accusing you of not really checking the patient at all?

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Call your malpractice carrier for guidance. If you have a union, have discussion with your delegate to keep them in the loop.

And I agree with the pp. Going forward, have the day nurse show you where the patch is as part of report. And it should be initialed and dated by the nurse who put it on--which would also could help you see it better.

Just to also throw it out there, most lido patches are 12 hours on, 12 hours off. Maybe the time to remove the patch is when you come in at 7pm if the patch has been on for the 12 hours? Another thought is that you both put the patch on at 7am?

I am not sure what the answer is, but it does seem really weird. I would not put anything in writing until talking to your insurance company.

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Well to make a long story short, they said I made the day shift nurse feel like she wasn't doing her job because I was circling my initials since the patch wasn't there. What's even more messed up is on the mar, the day shift nurse is supposed to document the site she placed the patch. Instead, she was just putting check marks. A copy of that Mar page was shown to me at the meeting I had with the don. I later went to work that night (I picked up a night shift.. And they took me off suspension) and someone went back over the Mar to the past days in question, and wrote lower back under that nurses initials. Like really? That's falsifying documentation..

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Well that's just plain ugly. I'd run.

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Well to make a long story short, they said I made the day shift nurse feel like she wasn't doing her job because I was circling my initials since the patch wasn't there. What's even more messed up is on the mar, the day shift nurse is supposed to document the site she placed the patch. Instead, she was just putting check marks. A copy of that Mar page was shown to me at the meeting I had with the don. I later went to work that night (I picked up a night shift.. And they took me off suspension) and someone went back over the Mar to the past days in question, and wrote lower back under that nurses initials. Like really? That's falsifying documentation..

And the plot thickens. You made the day shift nurse feel bad (waah-waah) and they cover her tracks and suspend you?!

Did you lose work over this? You need to move on stat, cover yourself first.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

This is all so messed up. I echo what everyone has said, call your & get another job. Someone wants you gone & they are trying hard to do it. I'm sorry you're going through this huge mess!

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This could be a learning opportunity. Have the RN reporting off SHOW YOU THE patch during report. With all I've heard recently about nurses diverting, it's the prudent thing to do for this very reason.

This does sound sketchy to me.

I can't say how important it is to double check the outgoing RN's work at shift change. It may stink because they just want to give report and leave, but whatever you didn't check becomes your mistakes.

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I have only seen one side of the story, but has anyone ever read Silas Marner by George Eliot? Sounds kind of familiar!

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